National palliative medicine survey looks at urban versus rural

by Rural Ontario Institute 3. June 2015 12:50

Since the “End-of-life care in rural communities” post on May 27, 2015, a new national survey on the topic has been published. Guest blogger Barry R. Ashpole of Guelph, Ontario, has provided the following commentary.

The Canadian Medical Association has now published the findings of a national survey of physicians in Canada - the first of its kind - who provide palliative care services.

The survey found that for 84% of respondents, palliative care was not their primary field of practice. Family physicians with a focused practice in palliative medicine and palliative medicine specialists – 16% of more than 1100 respondents – reported working an average of 36 hours per week in palliative care. Physicians who provide palliative care as part of their other clinical duties – 84% of respondents – reported working an average of seven hours providing palliative care services.

The survey also examined the differences between rural and urban areas for access to palliative care services. Just 35% of palliative medicine physicians in rural and remote areas reported having specialized palliative care teams to provide care in their area, compared to 79% of physicians in urban areas. Formal home health care for patients wishing to die at home was reported to be available by 49% of urban palliative medicine physicians versus 30% of rural physicians.

Canada must ensure minimum palliative medicine standards are met. Different strategies are needed for rural and urban settings to meet the needs of the population in a realistic yet appropriate way.

Additional information about the Canadian Medical Association survey can be found here:

End-of-life care in rural communities

by Rural Ontario Institute 27. May 2015 10:24

This commentary has been provided by Barry R. Ashpole of Guelph, Ontario. 

Two important human service issues have emerged in recent years and continue to generate a great deal of attention in both the political and public arenas: 

1) the pressure on the public purse for the future provision and delivery of health care and social services to the population-at-large; and,
2) meeting the needs of the elderly, who are living longer, in greater numbers than in past generations, and with a corresponding increase in the incidence of chronic or long-term illness or disability.

 Running parallel is the trend in many countries away from institutionalized care to accommodate the preference expressed by many people to receive care and support in their own home in the event of illness or incapacity. The potential economic benefits of that approach have not escaped policymakers, presenting them with a persuasive argument that suggests a significant shift in the focus and scope of community care in the decades ahead. Against this backdrop is the increasing attention on all fronts given to the quality of care and support for those living with a terminal illness, both patients and their families or loved ones. People living with a terminal illness in rural communities and remote regions, however, present a unique set of challenges; compared to urban centres, there are significant –  but not necessarily insurmountable – disparities in access to quality end-of-life care.

According to the 2011 Census, more than 6.3 million Canadians were living in rural or remote regions. At 18.9% of the population, this number has been relatively stable since 1991. A trend in recent years, however, has seen elderly city dwellers relocating to spend their retirement years in rural communities. Little is known about the perspectives of people living in these areas on what constitutes a “good death” and how this might be accomplished. A critical consideration, supported, literally, by volumes of research, is the wish of most people living with a terminal illness to be able to die at home. At the present time, the likelihood of receiving specialized home care services such as palliative care are markedly low in rural communities and remote regions.

In Ontario, as in all other provinces and territories in Canada, there are barriers to providing hospice and palliative care outside of urban centres, for example: 1) the lack of services; 2) health professionals unfamiliar with the philosophy and practice of palliative care; 3) limited access to resources; and, 4) continuity in the provision and delivery of care. And, more often than not, these barriers are even more pronounced among First Nation’s communities. Unfortunately, there is little strong evidence to inform policy and service development. Models of end-of-life care, however, do exist despite a general lack of health care professionals inexperienced or trained in end-of-life care and the resources to support them, their patients and patient families.

There is a clear need to initiate a province-wide dialogue, raise public awareness in the process, and address this issue at the local level. Many of the most successful hospice and palliative care programs in Canada have had their roots in community initiatives. Professional education and public awareness – and improved access to information and resources – are critical. Ultimately, the goal is to effect change at the policy making level of government, but there is much that communities can do now to address this public health issue.

About the blogger

My involvement in hospice and palliative care dates from 1985. As a communications consultant, I’ve been involved in or responsible for a broad range of initiatives at the community, regional, provincial and national level. My current focus is on advocacy and policy development in addressing issues specific to those living with a terminal illness – both patients and families. In recent years, I’ve applied my experience and knowledge to education for frontline care providers, developing and teaching on-line and in-class college courses on different aspects of end-of-life care.

Introducing the Rural Community Vitality Measurement Initiative

by Rural Ontario Institute 15. April 2015 11:21

We are pleased to share an exciting new project endeavour. Beginning in May 2015, we will be leading the Rural Community Vitality Measurement Initiative.

Funded by the Ministry of Municipal Affairs and Housing, this announcement represents a 30-month applied research and analysis initiative focused on deepening understanding of effective practices for quantifying rural civic engagement, social capital and community well-being. The initiative will also demonstrate methods for municipal evaluation of community impacts and social return on investment.

The viability and economic success of small towns and rural communities is closely related to a number of intangible factors which are hard to measure but integral to municipal functions. The overarching goal of the initiative is to assist rural stakeholders by undertaking projects which enable information sharing, capture practitioner insights and lessons learned, and facilitate peer exchange of best practices surrounding these hard to measure aspects.

The initiative includes seven research and knowledge transfer projects grouped under three themes. The projects will commence in May 2015 and conclude by August 2017.

Theme: Rural Municipal Leadership – Succession Planning
-Rural Councillor Profile
-Youth Civic Engagement Showcase

Theme: Showcasing Effective Measurement Approaches
-Tracking Citizen Participation and Engagement: Best Practice Resource
-Rural Case Studies of Social Return on Investment and Community Impact

Theme: Rural Quality of life and Community Well-being
-Rural Well-Being Reporting: Demonstration Project 
-Small Area Data Guide as related to the Focus on Rural Ontario fact sheet series
-Rural Foresight Papers

As a first step, we are currently seeking a Project Manager. Please see the job posting and description for details.

We are looking forward to engaging stakeholder organizations and collaborating with key partners on each of the above projects. If you are interested in the above themes and projects and would like to learn more, please comment here or contact Norman Ragetlie, Director, Policy and Stakeholder Engagement.


11 more Ontario municipalities to receive community transportation funding

by Rural Ontario Institute 14. April 2015 10:14

With the goal of improving transportation for youth, seniors and persons living with disabilities, Ontario has announced a new pilot grant program. As you know, 11 municipalities were selected in March 2015 to receive up to $100,000 to provide better transportation services through community resources.

As of yesterday we are pleased to share the news that an additional 11 municipalities have been selected to receive funding. The communities of Dryden, Temiskaming Shores, Muskoka, White River, Waterloo, York Region, Caledon, Peel, Hamilton, Northumberland and Lennox-Addington will be receiving up to $100,000 for their respective projects.

“The government of Ontario is happy to help municipalities provide more transportation options to their residents. Our transportation investments like the Community Transportation Pilot Grant Program help build stronger communities by helping residents stay connected to their communities and maintain an active lifestyle,” says Steve Del Duca, Minister of Transportation. 

Please click here to view the Ministry of Transportation news release and to learn more about the selected projects. 


Employment of rural youth in Ontario

by Rural Ontario Institute 13. April 2015 15:57

This commentary is related to the Focus on Rural Ontario fact sheets about youth employment. It is provided by Carol Simpson, Executive Director, Workplace Planning Board of Waterloo Wellington Dufferin.

From a Workplace Planning Board perspective, I am interested in the Rural Ontario Institute’s Focus on Rural Ontario fact sheet series.

Given our understanding of local data, somewhat surprisingly, despite increasing population growth in the 15 to 24 year old age categories, their labour force growth is not keeping pace.  Over the past year, we have seen unemployment rates among this age group drop as the number of young workers finding employment continues to rise. E.g. in the metro area of Waterloo Region, the number of young workers joining the labour force from January 2014 to January 2015 increased by only 1000, while 4000 more were employed in the same period. This is putting a strain on the already tight job market in the area.

Access to the Youth Employment Fund, provided through the Ministry of Training, Colleges and Universities, over the past year and a half may have had a significant impact, enabling young people to access employment opportunities by providing wage supports to employers who hired them.  It will be interesting to see if the discontinuation of this program impacts youth employment rates in a negative fashion over the next few months.

In some non-metro parts of my area, youth participation rates continue to decline, perhaps due to youth becoming disengaged from the labour force. It’s not the first time I’ve heard of a rural business rotating through the local youth population several times but they are not able to retain these young workers initially. When these young workers come back later, realizing that this was actually a good opportunity, in many instances they find the doors closed on them. With few other local opportunities they lose interest and stop looking for work. Businesses may have to reconsider not rehiring formerly unsuccessful young workers, when they re-enter the workforce at some later stage, in order to meet their labour demands.

With many non-metro region populations struggling to maintain and/or grow their labour force, youth re-engagement and youth retention are forefront in many workforce development strategies and initiatives across my area and other parts of Ontario.


Ontario municipalities to receive community transportation funding

by Rural Ontario Institute 18. March 2015 13:27

With the goal of improving transportation for youth, seniors and persons living with disabilities, Ontario has announced a new pilot grant program. As of today, 11 municipalities have been selected to receive up to $100,000 to provide better transportation services through community resources.

The communities of Atikokan, Terrace Bay, Papineau-Cameron, Haliburton, Black River-Matheson, Grey, Tillsonburg, Georgina, Simcoe, Pelham and Prescott & Russell will be receiving funding for their respective projects.

“The government of Ontario is committed to ensuring better access to transportation services for all residents, so that they can stay connected to their communities and maintain an active lifestyle. Our transportation investments like the Community Transportation Pilot Grant Program help build stronger communities,” says Steven Del Duca, Minister of Transportation.

Ministry of Transportation news release is available here.

More information on the selected municipalities is available here.


Town of Minto Awarded Bronze Designation as part of Walk Friendly Ontario

by Rural Ontario Institute 15. January 2015 13:30

The following is a guest blog from Belinda Wick-Graham, Business & Economic Development Manager, Town of Minto. 

On December 3, 2014 the Town of Minto was awarded a bronze designation as part of the Walk Friendly Ontario recognition program. This program works to “encourage municipalities to create and improve spaces and places to walk”.

The Town of Minto is a small rural municipality with a population of approximately 9,000 people spread amongst the communities of Clifford, Harriston, Palmerston and the former Minto Township and has been actively involved in developing a Walkable Community since 2005 and actually presented at the Walk21 International Conference on Walkability, which was held in Toronto in 2007.

Some of the initiatives that have been undertaken in Minto include:

-Touring other walkable neighbourhoods and bringing some of these sustainability guidelines back to Minto in the form of a Sustainable Community Guidelines for Development & Developers that was unanimously approved by Council.

- The Council of the Town of Minto has signed and supports the International Charter for walking.

- We have worked with University of Guelph Masters’ students to identify potential trail linkages and communicate with local landowners to determine a route.

- 3rd Year University of Guelph Landscape Architecture students were engaged to develop streetscape ideas that improved walking and cycling, these ideas then fed into a downtown Streetscape Plan that was unanimously approved and implemented by Council. This includes the development and creation of several public spaces in the downtown core.

- Minto is a key member of the Wellington County Active Transportation Plan process that links all 7 municipalities and the County to 49 trails/routes that connect into Wellington County and we have supported the development of trail signage standards and interpretive signage standards.

Walkable Communities are a key component of the Town of Minto Strategic Plan. We all know the health benefits of walking and we want to make it easy and enjoyable for our residents to be physically active but there are also numerous economic benefits associated with walkable communities.

a.      Higher Housing Values

b.      Attracting New Economy Workers

c.       Attracting Tourists

d.      Businesses are Relocating to Walkable Communities

e.      Walkability assists Retail Markets and Downtowns

Today more than at any other time in history, thanks largely to technology people are choosing where they want to live over where they are going to work. In Minto we are trying to build a community that has a strong quality of life, and building a walkable community is part of that. Generally, communities that are safe, attractive, environmentally sound, diverse

and culturally rich are not only desirable places to live, but tend to thrive economically.

It is no longer good enough to have decent infrastructure (roads, water, and sewer). Solid infrastructure is important, but if we don’t provide that quality of life element we will quickly see our population decline and we will not be able to afford to pay for that infrastructure.  This is one of the reasons why the Town of Minto invests in building a Walkable Community. The Walk Friendly Ontario designation will be used to not only expand and improve our efforts but to promote our community.




Ministry of Education Proposes Major Changes to School Closure Processes

by Rural Ontario Institute 10. December 2014 12:59

Major changes have been quietly proposed in the Pupil Accommodation Review Guidelines (PARG) that the Ministry of Education sets as the minimum standards which school boards must follow when considering closing schools. The extremely limited timeline for commenting on these proposed changes suggests the Ministry is not prepared to have an extended public discussion about this even though many rural stakeholders would likely be concerned about the potential impact of the changes especially for communities that have only a single school. See for example all the work of the Community Schools Alliance which argued strenuously for more flexibility in those circumstances.

The new proposed guidelines would actually remove consideration of the community impacts from the purview of the reviews and reduce public meeting requirements.

Strangely, the unseemly haste with this consultation appears at odds with the mandate letters to the Ministers of Education and Municipal Affairs and Housing which included the development of policy regarding the role schools could play as community hubs. Developing schools as community hubs implies processes to form partnerships and innovation for collaborative use of school buildings with a combination of public benefit uses. It seems a reasonable way to ensure important community assets remain viable and contribute to community well-being and especially relevant where there may be a single school in the community and declining enrollment. Shouldn’t the new guidelines encourage Accommodation Review processes to consider these types of outcomes and not just narrow the scope of the review process to student achievement as now proposed? Perhaps the Ministry should consider this.

The consultation document can be found here on the People for Public Education website which also includes a good summary of the changes:

Likewise, the Association of Municipalities of Ontario is informing its members of the proposed changes because of the impact on municipal representation in the process. 

The Ministry is accepting feedback until December 18 2014 and suggesting the proposed Guidelines would become effective in January 2015. Feedback can be sent to:


Age-Friendly Community Planning Grant Announced

by Rural Ontario Institute 26. November 2014 10:42

The following guest blog is provided by the Ontario Seniors’ Secretariat.

The Ontario Seniors’ Secretariat has launched the Age-Friendly Community Planning Grant program and will be accepting applications through Grants Ontario until Friday January 30, 2015, at 5:00pm (EST). All project activity must be completed by March 31, 2017.  Priority will be given to projects that target small municipalities and communities with diverse populations, and those in rural and remote areas of Ontario. Priority will also be given to communities that have not yet begun age-friendly community planning work or do not have a local age-friendly action plan. With an investment of $1.5 million over two-years, the program will support strategic planning activities that make communities more age-friendly, helping seniors contribute to all aspects of community life.  See the News Release and Backgrounder for further information. 

The funding levels for the grant program are based on population size:

•          Up to $25,000 for small communities (under 20,000 residents)

•          Up to $35,000 for medium-sized communities (20,000 to 99,999 residents)

•          Up to $50,000 for larger communities (more than 100,000 residents).




Community Transportation Pilot Grant Program Announced

by Rural Ontario Institute 26. November 2014 10:31

This guest blog has been provided by the Ministry of Transportation

The Ministry of Transportation is pleased to announce the launch of the Community Transportation Pilot Grant Program.  With this grant program, we invite municipalities across the Province to work with local community organizations to propose community transportation projects.  The Ministry is making available $1 million over two years to assist communities in improving transportation options and access through the coordination of services and the sharing of transportation resources.  Grant applications will be accepted until January 30, 2015, 5:00 pm EST.

More information can be found in the News Release - English and News Release - French and details of the grant program, eligibility requirements, and the application form are available at the Ministry of Transportation website.